Enbrel (etanercept) — CareFirst (Caremark)
Active non-radiographic axial spondyloarthritis (nr-axSpA)
Initial criteria
- Age ≥ 18 years
- Member has inadequate response to at least two NSAIDs; OR intolerance or contraindication to two or more NSAIDs
Reauthorization criteria
- Chart notes or medical record documentation supporting positive clinical response
Approval duration
12 months